浅谈血球计数的常见问题处理

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                    <p style=""><span style="font-size: 16px;">通过血细胞计数分析可以了解患者血液的基本信息。比如有无感染、有无贫血、是否有凝血功能障碍等。一般是必做的检查。</span></p><p style=""><span style="font-size: 16px;">　　</span></p><p style=""><span style="color: rgb(84, 141, 212);"><strong><span style="font-size: 16px;">一、计数偏高</span></strong></span><span style="font-size: 16px;">，这里指的是总体的偏高，不是针对特例，一个或者几个项目在一段时间内或者一批标本里面总是偏高，那么，首先分析标本人群的特殊性。例如，白细胞增高是不是发烧感染人群，血红蛋白增高是不是高原人群等等，排除这些就需要从试剂和仪器还有抗凝剂几个方面进行考虑，抗凝剂不好会造成分类和血小板的增高，严重的（错用抗凝剂）会导致红细胞和白细胞的增高，试剂不好一般是错用了稀释液和容血剂，仪器本身一般不会造成偏高，除非电路上错误的调整或者定标系数被错误的更改。</span></p><p style=""><span style="font-size: 16px;">　　</span></p><p style=""><span style="color: rgb(84, 141, 212);"><strong><span style="font-size: 16px;">二、计数偏低</span></strong></span><span style="font-size: 16px;">，一般是堵孔，负压不足，管道泄露等因素，堵孔的情况在有些机器上一般偏低三分之一到三分之二，在显微镜下能明显看到小孔周围的沉积物，需要浸泡或者其它处理方式，拆卸小孔时一定要注意，安装时一定要小心不要挤破小孔，在血红蛋白比色和计数池分离的仪器上，可以在池内进行高浓度清洗操作，因为不用担心计数池的透光性，但在血红蛋白比色和细胞计数池为一体的机器上，尽量不要这么做，可采取将小孔拆下来浸泡，以免影响计数池的透光性，造成血红蛋白不正常。</span></p><p style=""><span style="font-size: 16px;">　　</span></p><p style=""><span style="color: rgb(84, 141, 212);"><strong><span style="font-size: 16px;">三、计数不稳定</span></strong></span><span style="font-size: 16px;">，这种情况首先检查进样系统是否造成进样本身不准确，单纯的白细胞不稳，首先考虑溶血剂的问题，是否过期，是否与该仪器匹配，试剂加液量是否稳定（也就是检查溶血剂的加样系统是否完好）；单纯的红细胞部分计数不稳定，要考虑二次稀释的加液量问题。当然，在分析上述问题前，要首先保证计数池及管路没有问题。补充说明一点，由于白细胞配液的混匀采用打气泡的方式，如果在计数过程中，打气泡的开关阀关不紧，有漏气现象，就会造成计数的不稳定，在维修过程中要注意观察。</span></p><p style=""><span style="font-size: 16px;">　　</span></p><p style=""><strong><span style="font-size: 16px; color: rgb(84, 141, 212);">四、</span></strong><span style="font-size: 16px;"><span style="font-size: 16px; color: rgb(84, 141, 212);"><strong>重复性差的问题</strong></span>，首先要考虑上述原因，其次，增益或灵敏度调整的不好，会造成仪器的线性变差，重复性变差。</span></p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" data-ratio="0.14784394250513347" data-w="487" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0?tp=webp" style="margin: 0px; padding: 0px; box-sizing: border-box !important; word-wrap: break-word !important; visibility: visible !important; width: auto !important;"  /></p><p style=""><legend style="margin: 0px; padding: 0px; max-width: 100%; white-space: normal; color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="margin: 0px; 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